Private Health Information Statement - Combined policy

Medibank Gold Premier Signature

Monthly Premium

$675.50 #

(before any rebate, loading or discount)

Covers one adult & dependants (2 or more people, only one of whom is an adult)

Available in Northern Territory

# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading, an age-based discount or an insurer discount. Check with your insurer for details.

This policy covers children and other dependants up to and including the age of 20, students up to and including the age of 30, as well as persons with a disability who qualify as a child or other dependant or student in these age ranges.

Hospital cover

This policy exempts you from the Medicare Levy Surcharge.

This policy provides accident cover and benefits for travel or accommodation (outside of hospital) - check with your insurer for details.

This policy includes cover for

Hospital Cover Legend
Assisted reproductive servicesEye (not cataracts)Miscarriage and termination of pregnancy
Back, neck and spineGastrointestinal endoscopyPain management
BloodGynaecologyPain management with device
Bone, joint and muscleHeart and vascular systemPalliative care
Brain and nervous systemHernia and appendixPlastic and reconstructive surgery (medically necessary)
Breast surgery (medically necessary)Hospital psychiatric servicesPodiatric surgery (provided by a registered surgical podiatrist – limited benefits)
CataractsImplantation of hearing devicesPregnancy and birth
Chemotherapy, radiotherapy and immunotherapy for cancerInsulin pumpsRehabilitation
Dental surgeryJoint reconstructionsSkin
Diabetes management (excluding insulin pumps)Joint replacementsSleep studies
Dialysis for chronic kidney failureKidney and bladderTonsils, adenoids and grommets
Digestive systemLung and chestWeight loss surgery
Ear, nose and throatMale reproductive system

The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.

Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.

The following payments may also apply for hospital admissions

Excess: No excess

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members

Waiting periods:

  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 12 months for pregnancy and birth (obstetrics)
  • 2 months for all other treatments

Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product.

The Medical Costs Finder lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

Comprehensive cover. No Excess or Co-payments required. Private Room Promise for pre-booked admissions at a Members' Choice hospital. Up to $1,000 CPAP benefit per member towards hire or purchase of an approved device, a rolling 5-year benefit replacement period applies.

General Treatment Cover

At Members' Choice extras providers you may get more for your cover. This includes 100% back on a dental check up, scale and clean each year and great optical deals. See https://www.medibank.com.au/health-insurance/find-provider/#/.

This policy includes General treatment (Extras) cover for

General treatment legend
Note, for items marked with an asterisk *: 12 moth waiting period applies to surgical dental extraction.
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental*2No annual limitPeriodic oral examination - $38.80
Scale & clean - $61.50
Fluoride treatment - $19.80
Surgical tooth extraction - $62.90
Major dental12$2,000 per person
(combined limit for major dental & endodontic)
Full crown veneered - $680.00
Endodontic12Filling of one root canal - $100.00
Orthodontic12$800 per person
$2,400 lifetime limit for Orthodontic
Braces for upper & lower teeth, including removal plus fitting of retainer - 100% of charge
Optical6$250 per personSingle vision lenses & frames - 100% of charge
Multi-focal lenses & frames - 100% of charge
Non PBS pharmaceuticals2$600 per personPer eligible prescription - $40.70
Physiotherapy2$700 per personInitial visit - $42.20
Subsequent visit - $30.60
Chiropractic2$400 per person
(combined limit for chiropractic & osteopathy)
Initial visit - $43.00
Subsequent visit - $26.40
Podiatry2$400 per person
(combined limit for podiatry & orthotics (podiatric orthoses))
Initial visit - $31.80
Subsequent visit - $20.20
Psychology0$400 per personInitial visit - $123.62
Subsequent visit - $102.37
Acupuncture2$400 per personInitial visit - $34.40
Subsequent visit - $21.00
Remedial massage2$200 per person
(combined limit for remedial massage, chinese medicine & exercise physiology)
Initial visit - $25.00
Subsequent visit - $25.00
Hearing aids36$800 per personHearing aid - $800.00
Blood glucose monitors24$240 per personPer monitor - $180.00
Chinese medicine2Combined limit - see Remedial massageInitial visit - $25.00
Subsequent visit - $25.00
Dietetics/dietary advice2$400 per personInitial visit - $46.10
Subsequent visit - $21.00
Exercise physiology2Combined limit - see Remedial massageInitial visit - $25.00
Subsequent visit - $25.00
Eye therapy (orthoptics)2$400 per personInitial visit - $24.50
Subsequent visit - $20.40
Occupational therapy2$400 per personInitial visit - $46.10
Subsequent visit - $29.40
Orthotics (podiatric orthoses)2Combined limit - see PodiatryOrthotics supply & fit - 80% of charge
Osteopathy2Combined limit - see ChiropracticInitial visit - $43.00
Subsequent visit - $26.40
Speech therapy2$400 per personInitial visit - $76.30
Subsequent visit - $32.40
Health appliances and external prostheses: 2month waiting period. Breathing appliances: 12 month waiting period, fixed benefits, benefit replacement periods apply. School accident: Apply to pre-school, primary and secondary school students only, 2 month waiting period, fixed benefit and annual limit of $800 apply. PackageBonus: 6 month waiting period apply, starts at $50 for singles and $100 couple/family per year. Counselling: (no waiting period) shares an annual limit with psychology. Blood pressure monitors: 12 month waiting period and benefit replacement period apply, share an annual limit with blood glucose monitors. Contact Medibank for more information.

This policy does not include General treatment (Extras) cover for

General treatment legend
Other treatments - check with your insurer

Other features of this general treatment cover

Comprehensive hospital and extras cover in one convenient package. Rewards you with a PackageBonus to use towards approved health and membership expenses.

Ambulance cover

In Northern Territory this policy provides:

Emergency: Unlimited with a waiting period of 1 day.

Call-out fees:  will be paid for each attendance, including emergency treatment without transport to hospital.

Other features of this ambulance cover

Cover for an ambulance when you require immediate professional attention and you need to be transported to hospital or other approved facility and your medical condition is such that you cannot be transported any other way, or where an ambulance is called but transport is not needed. Cover for air ambulance where pre-approval has been obtained from Medibank. In all cases the ambulance provider must be Medibank approved. Please contact Medibank for further details.

Disclaimer

The information contained in this Private Health Information Statement was provided by the insurer and is intended as general information. It may not take into account your particular circumstances. For information please contact the insurer.

Covered

For information on what is covered under each category, see https://www.privatehealth.gov.au/categories

Restricted

Restricted categories partially cover your hospital costs as a private patient in a public hospital. You may incur significant expenses in a private room or private hospital.

Not Covered

These categories are not covered by this policy.